The intrauterine artificial insemination consists of the introduction or deposit of a non-natural form of semen into the uterine cavity of the woman (approach of gametes) in order to achieve a pregnancy. The semen has been previously processed in the andrology laboratory. It is a technique of assisted reproduction of low complexity. The main objective is to increase the pregnancy rate in a specific cycle by matching a high concentration of sperm in the fallopian tube with the time of ovulation. The semen is previously stimulated and controlled by the reproductive doctor. This is a procedure of high security and simplicity, which is why it is done in the office. To ensure the effectiveness, the preparation of the seminal sample must be done by a specialized Andrology Laboratory.
Intrauterine Artificial Insemination is recommended in the following cases:
- Slight and moderate seminal pathologies (Asthenozoospermia, mild Oligozoospermia)
- Sterility of Unknown Origin
- Ovulatory dysfunction
- Uterine Factor
- Cervical Factor
- Inability of the man to deposit semen in the vagina
The couple must comply with the following requirements in order for the Intrauterine Artificial Insemination to have a therapeutic scope:
- The woman must be under 38 years of age, with adequate ovarian reserve
- Both permeable, healthy and caudal-oriented tubes
- Recovery of Mobile Sperm (REM) above 5 million, with a sperm morphology greater than 4% according to strict Kruger criteria.
Once the therapeutic indication has been established in compliance with the earlier mentioned requirements, the treatment begins. The treatment consists of the following phases:
- Controlled ovarian stimulation: Hormonal or non-hormonal drugs are administered to stimulate follicular growth. This stimulation must be accompanied by ultrasound and laboratory tests to check the ovarian response of the patient. The dose will depend on age, ovarian reserve and Body Mass Index. Once adequate follicular growth has been achieved, Ovulation-inducing drugs are administered to guarantee oocyte maturation and follicular rupture (Ovulation) at the required time.
- Preparation of the seminal sample: The seminal sample is processed in the Andrology Laboratory of the Unit. This preparation consists of selecting and concentrating the mobile sperm through washing techniques and sperm capacitation. When these techniques are applied, cell debris and dead or immobile sperm are removed from the semen.
Intrauterine insemination is done in the office. It is a simple and non-painful procedure, which does not require administering anesthesia. The procedure consists off introducing the seminal sample (already washed and capable) to the inside of the uterus. This is done by the use of a cannula specially designed for this purpose, which is passed through the Orifice of the cervix. After insemination, the patient must remain a few minutes at rest and can return to her daily activities afterwards. The obtained results for gestation per cycle with homologous artificial insemination and using semen from the partner, is around 20%. This means that out of every 100 cycles of insemination, about 20 result in gestation, and of every 100 couples that complete 4 cycles, 60 get gestation.